Document Detail


Prediction of graft flow impairment by intraoperative transit time flow measurement in off-pump coronary artery bypass using arterial grafts.
MedLine Citation:
PMID:  16039211     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We assessed the validity of intraoperative transit time flow measurement (TTFM) in predicting graft flow abnormalities. METHODS: Intraoperative graft flow measurement using TTFM and early postoperative coronary angiography was performed in 58 patients who underwent total arterial off-pump coronary artery bypass. Five variables (flow pattern, mean flow, pulsatility index, insufficiency ratio, and fast Fourier transformation ratio) were measured and compared between 103 normal and 14 abnormal (occluded or competitive) grafts. RESULTS: The grafts anastomosed to the right coronary territories showed significantly less diastolic dominant pattern, lower mean flow and fast Fourier transformation ratio, and higher pulsatility index than grafts to the left coronary artery territories (p < 0.05). None of the abnormal grafts showed a diastolic dominant flow pattern. The abnormal grafts demonstrated significantly lower mean flow and fast Fourier transformation ratio and higher pulsatility index and insufficiency ratio than normal grafts (p < 0.05). When our criteria for detection of abnormal graft flow, [(1) systolic dominant or balanced pattern of the flow curve in the left coronary territories, systolic dominant pattern of the flow curve in the right coronary territories; (2) mean flow < 15 mL/min; (3) pulsatility index > 3 in the left coronary territories and > 5 in the right coronary territories; and (4) insufficiency ratio > 2%] were applied, the sensitivity and specificity of TTFM to detect the graft flow abnormality were 96.2% and 76.9%, respectively. CONCLUSIONS: Our data suggest that TTFM is a reliable intraoperative tool to predict graft flow impairment.
Authors:
Ki-Bong Kim; Chang Hyun Kang; Cheong Lim
Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  80     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-25     Completed Date:  2006-09-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  594-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. kimkb@snu.ac.kr
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Artery Bypass, Off-Pump*
Coronary Artery Disease / diagnosis,  surgery
Coronary Circulation*
Humans
Intraoperative Period
Predictive Value of Tests
Time Factors
Vascular Patency*
Comments/Corrections
Comment In:
Ann Thorac Surg. 2005 Aug;80(2):599   [PMID:  16039212 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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